- Point32Health (Canton, MA)
- …business division goals. This position will report to the Director of Risk Adjustment Strategy, Operations and Quality Assurance. **Job Description** + ... of standard (and ad hoc) analyses to improve awareness and understanding of risk adjustment results and the quality , accuracy and identification of member… more
- Ankura (New York, NY)
- …operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also ... of activities: + Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit, and investigation projects for clients. +… more
- Avera (Sioux Falls, SD)
- …Healthcare Effectiveness Data Information Sets (HEDIS). The Quality and Risk Adjustment Specialist will work closely with the Director of Quality and ... Risk Services, Manager of Risk Adjustment , Manager of Quality , Quality Coordinator - HEDIS, coder(s), claims staff, and primary care & specialty care… more
- Bristol Myers Squibb (New Brunswick, NJ)
- …critical to quality (CtQ) data, processes, and vendors, demonstrating effective risk and issue management. Provide quality and compliance consultation to ... at a study and/or ASSET and TA level, to document the end-to-end risk -based quality management for CtQ data, processes and vendors demonstrating effective… more
- Catholic Health Initiatives (Little Rock, AR)
- …for the value hub. + Through Risk Management/Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and Kentucky CIN. + ... to 25-50% professional travel may be involved. + Supports quality , clinical practice, safety, risk coding, compliance,...Health Management experience required + Must have experience with risk adjustment coding and value based reimbursement… more
- Molina Healthcare (MI)
- …Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment , is responsible for the implementation, monitoring, and oversight ... of all chart collection for Risk Adjustment , RADV, or ...coding. This role also works with the Health Plan Risk / Quality leaders to strategically plan for supplemental… more
- Bristol Myers Squibb (Seattle, WA)
- …Controls for processes, including Management Responsibility, Event Management, Change Management, and Quality Risk Management, with a primary focus on regulatory ... to strategically prepare for and manage regulatory inspections, applying principles of Quality Risk Management to ensure inspection readiness and compliance.… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …performing team responsible for maintaining, executing, and evaluating initiative impacts using the risk adjustment and quality analytics models across ACA ... of data submissions for ACA Commercial, Medicare, and Medicaid risk adjustment and quality programs....Education Required Required Skills and Experience * Accepting this director level position at BCBSMN requires signing an Employee… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …identify risks and opportunities for improvement. * Collaborate with Pharmacy, Risk Adjustment , Network Management, Care Management, Member Experience, Medical ... Blue Cross and Blue Shield of Minnesota Position Title: Director of Value Performance Quality Location: Hybrid...Minnesota Position Title: Director of Value Performance Quality Location: Hybrid | Eagan, Minnesota Career Area: Customer… more
- Mount Sinai Health System (New York, NY)
- …CDQI, who will (1) be responsible for driving key population health goals including access, quality , utilization and accurate risk adjustment with a group of ... practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment...hardwiring processes to drive excellence in efficiency of care, quality and accurate risk adjustment … more
- Bristol Myers Squibb (Princeton, NJ)
- …(GDO), the Director GTL is responsible for critical decision making, risk management, and fostering a culture of innovation and continuous improvement. Works ... forecasts, accruals, and cost optimization to ensure financial accuracy and efficiency. ** Risk & Quality Management:** + Advanced leadership competencies with… more
- CenterWell (Tallahassee, FL)
- …interrelate across the function or segment. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing ... caring community and help us put health first** The Director , Medical Coding extracts clinical information from a variety...Responsible for performance management and strategy development for PCO risk adjustment at the division and market… more
- Point32Health (NH)
- …and will work in a matrix environment collaborating with functions including risk adjustment , population health, finance, operations, actuarial, and sales. **Job ... to enable high performing provider networks that support goals for membership growth, quality , and financial performance. The Director will foster and maintain… more
- Bristol Myers Squibb (Princeton, NJ)
- …improvement. * Cultivate and sustain strategic partnerships with External Engagement, Quality Risk Management and Operations & Performance to identify, ... lives. Read more: careers.bms.com/working-with-us . **Position Summary** Reporting to the Director , Inspection Readiness, the Associate Director will help drive… more
- Scripps Health (San Diego, CA)
- …of ICD, CPT, and HCPCS coding systems, MS-DRG/APR-DRG methodologies, and risk adjustment /HCC principles. * Strong technical proficiency and experience ... *This Senior Director position is eligible to participate in the...fee services. This role is responsible for advancing documentation quality , coding accuracy, and compliance to ensure the integrity… more
- CenterWell (Hampton, VA)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, combining… more
- RELX INC (Alpharetta, GA)
- …You can learn more about LexisNexis Risk at the link below. https:// risk .lexisnexis.com/insurance About the Role As the Senior Director of Marketplace and ... About the Business LexisNexis Risk Solutions is the essential partner in the...drive thought leadership through innovative market messaging. The Senior Director , Marketplace and Lead Solutions will also be responsible… more
- HCA Healthcare (Salt Lake City, UT)
- …practice leadership and internal stakeholders. + Oversee implementation of care coordination, risk adjustment , and quality improvement initiatives. + ... the successful execution of value-based care initiatives by driving performance across quality , financial, and operational outcomes. The Director serves as a… more
- CenterWell (Jacksonville, FL)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, combining… more
- CenterWell (Columbia, SC)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, combining… more